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Marijuana,
Cannabis Sativa, is a fast-growing annual plant of the
Cannabaceae family whose flowers produce the
psychoactive chemical THC. In recent years, there has
been debate amongst the medical and research community
regarding the utility of marijuana for medicinal
purposes. Currently, 12 states have medical marijuana
laws, but Indiana has no law permitting the use of
marijuana for medicinal
purposes.

Marijuana is
the most commonly abused illicit drug in the United
States. A dry, shredded green/brown mix of flowers,
stems, seeds, and leaves of the hemp plant Cannabis
sativa, it usually is smoked as a cigarette (joint,
nail), or in a pipe (bong). It also is smoked in blunts,
which are cigars that have been emptied of tobacco and
refilled with marijuana, often in combination with
another drug. It might also be mixed in food or brewed
as a tea. As a more concentrated, resinous form it is
called hashish and, as a sticky black liquid, hash oil.
Marijuana smoke has a pungent and distinctive, usually
sweet-and-sour odor. There are countless street terms
for marijuana including pot, herb, weed, grass, widow,
ganja, and hash, as well as terms derived from
trademarked varieties of cannabis, such as Bubble Gum,
Northern Lights, Fruity Juice, Afghani #1, and a number
of Skunk varieties.
The main active chemical in
marijuana is THC (delta-9-tetrahydrocannabinol). The
membranes of certain nerve cells in the brain contain
protein receptors that bind to THC. Once securely in
place, THC kicks off a series of cellular reactions that
ultimately lead to the high that users experience when
they smoke marijuana.
Effects
on the Brain
Scientists
have learned a great deal about how THC acts in the
brain to produce its many effects. When someone smokes
marijuana, THC rapidly passes from the lungs into the
bloodstream, which carries the chemical to organs
throughout the body, including the brain.
In the
brain, THC connects to specific sites called cannabinoid
receptors on nerve cells and influences the activity of
those cells. Some brain areas have many cannabinoid
receptors; others have few or none. Many cannabinoid
receptors are found in the parts of the brain that
influence pleasure, memory, thought, concentration,
sensory and time perception, and coordinated
movement.
The short-term effects of marijuana can
include problems with memory and learning; distorted
perception; difficulty in thinking and problem solving;
loss of coordination; and increased heart rate. Research
findings for long-term marijuana abuse indicate some
changes in the brain similar to those seen after
long-term abuse of other major drugs. For example,
cannabinoid (THC or synthetic forms of THC) withdrawal
in chronically exposed animals leads to an increase in
the activation of the stress-response system and changes
in the activity of nerve cells containing dopamine.
Dopamine neurons are involved in the regulation of
motivation and reward, and are directly or indirectly
affected by all drugs of
abuse.
Effects on the
Heart
One study has
indicated that an abuser's risk of heart attack more
than quadruples in the first hour after smoking
marijuana. The researchers suggest that such an effect
might occur from marijuana's effects on blood pressure
and heart rate and reduced oxygen-carrying capacity of
blood.
Effects on the
Lungs
A study of 450
individuals found that people who smoke marijuana
frequently but do not smoke tobacco have more health
problems and miss more days of work than nonsmokers.
Many of the extra sick days among the marijuana smokers
in the study were for respiratory illnesses.
Even
infrequent abuse can cause burning and stinging of the
mouth and throat, often accompanied by a heavy cough.
Someone who smokes marijuana regularly may have many of
the same respiratory problems that tobacco smokers do,
such as daily cough and phlegm production, more frequent
acute chest illness, a heightened risk of lung
infections, and a greater tendency to obstructed
airways. Smoking marijuana possibly increases the
likelihood of developing cancer of the head or neck. A
study comparing 173 cancer patients and 176 healthy
individuals produced evidence that marijuana smoking
doubled or tripled the risk of these
cancers.
Marijuana abuse also has the potential
to promote cancer of the lungs and other parts of the
respiratory tract because it contains irritants and
carcinogens. In fact, marijuana smoke contains 50 to 70
percent more carcinogenic hydrocarbons than does tobacco
smoke. It also induces high levels of an enzyme that
converts certain hydrocarbons into their carcinogenic
form—levels that may accelerate the changes that
ultimately produce malignant cells. Marijuana users
usually inhale more deeply and hold their breath longer
than tobacco smokers do, which increases the lungs'
exposure to carcinogenic smoke. These facts suggest
that, puff for puff, smoking marijuana may be more
harmful to the lungs than smoking
tobacco.
Other Health
Effects
Some of
marijuana's adverse health effects may occur because THC
impairs the immune system's ability to fight disease. In
laboratory experiments that exposed animal and human
cells to THC or other marijuana ingredients, the normal
disease-preventing reactions of many of the key types of
immune cells were inhibited. In other studies, mice
exposed to THC or related substances were more likely
than unexposed mice to develop bacterial infections and
tumors.
Effects of Heavy
Marijuana Use on Learning and Social
Behavior
Research
clearly demonstrates that marijuana has the potential to
cause problems in daily life or make a person's existing
problems worse. Depression, anxiety, and personality
disturbances have been associated with chronic marijuana
use. Because marijuana compromises the ability to learn
and remember information, the more a person uses
marijuana the more he or she is likely to fall behind in
accumulating intellectual, job, or social skills.
Moreover, research has shown that marijuana’s adverse
impact on memory and learning can last for days or weeks
after the acute effects of the drug wear
off.
Students who smoke marijuana get lower
grades and are less likely to graduate from high school,
compared with their nonsmoking peers. A study of 129
college students found that, among those who smoked the
drug at least 27 of the 30 days prior to being surveyed,
critical skills related to attention, memory, and
learning were significantly impaired, even after the
students had not taken the drug for at least 24 hours.
These "heavy" marijuana abusers had more trouble
sustaining and shifting their attention and in
registering, organizing, and using information than did
the study participants who had abused marijuana no more
than 3 of the previous 30 days. As a result, someone who
smokes marijuana every day may be functioning at a
reduced intellectual level all of the time.
More
recently, the same researchers showed that the ability
of a group of long-term heavy marijuana abusers to
recall words from a list remained impaired for a week
after quitting, but returned to normal within 4 weeks.
Thus, some cognitive abilities may be restored in
individuals who quit smoking marijuana, even after
long-term heavy use.
Workers who smoke marijuana
are more likely than their coworkers to have problems on
the job. Several studies associate workers' marijuana
smoking with increased absences, tardiness, accidents,
workers' compensation claims, and job turnover. A study
among postal workers found that employees who tested
positive for marijuana on a pre-employment urine drug
test had 55 percent more industrial accidents, 85
percent more injuries, and a 75-percent increase in
absenteeism compared with those who tested negative for
marijuana use. In another study, heavy marijuana abusers
reported that the drug impaired several important
measures of life achievement including cognitive
abilities, career status, social life, and physical and
mental health.
Effects of Exposure
During Pregnancy
Research has
shown that some babies born to women who abused
marijuana during their pregnancies display altered
responses to visual stimuli, increased tremulousness,
and a high-pitched cry, which may indicate neurological
problems in development. During the preschool years,
marijuana-exposed children have been observed to perform
tasks involving sustained attention and memory more
poorly than nonexposed children do. In the school years,
these children are more likely to exhibit deficits in
problem-solving skills, memory, and the ability to
remain attentive.
Addictive
Potential
Long-term
marijuana abuse can lead to addiction for some people;
that is, they abuse the drug compulsively even though it
interferes with family, school, work, and recreational
activities. Drug craving and withdrawal symptoms can
make it hard for long-term marijuana smokers to stop
abusing the drug. People trying to quit report
irritability, sleeplessness, and anxiety32.
They also display increased aggression on psychological
tests, peaking approximately one week after the last use
of the drug33.
Genetic
Vulnerability
Scientists have
found that whether an individual has positive or
negative sensations after smoking marijuana can be
influenced by heredity. A 1997 study demonstrated that
identical male twins were more likely than nonidentical
male twins to report similar responses to marijuana
abuse, indicating a genetic basis for their response to
the drug. (Identical twins share all of their
genes.)
It also was discovered that the twins'
shared or family environment before age 18 had no
detectable influence on their response to marijuana.
Certain environmental factors, however, such as the
availability of marijuana, expectations about how the
drug would affect them, the influence of friends and
social contacts, and other factors that differentiate
experiences of identical twins were found to have an
important effect.
Treating Marijuana
Problem
The latest
treatment data indicate that, in 2002, marijuana was the
primary drug of abuse in about 15 percent (289,532) of
all admissions to treatment facilities in the United
States. Marijuana admissions were primarily male (75
percent), White (55 percent), and young (40 percent were
in the 15-–19 age range). Those in treatment for primary
marijuana abuse had begun use at an early age; 56
percent had abused it by age 14 and 92 percent had
abused it by 18.
One study of adult marijuana
abusers found comparable benefits from a 14-session
cognitive-behavioral group treatment and a 2-session
individual treatment that included motivational
interviewing and advice on ways to reduce marijuana use.
Participants were mostly men in their early thirties who
had smoked marijuana daily for more than 10 years. By
increasing patients' awareness of what triggers their
marijuana abuse, both treatments sought to help patients
devise avoidance strategies. Abuse, dependence symptoms,
and psychosocial problems decreased for at least 1 year
following both treatments; about 30 percent of the
patients were abstinent during the last 3-month followup
period.
Another study suggests that giving
patients vouchers that they can redeem for goods—such as
movie passes, sporting equipment, or vocational
training—may further improve outcomes.
Although
no medications are currently available for treating
marijuana abuse, recent discoveries about the workings
of the THC receptors have raised the possibility of
eventually developing a medication that will block the
intoxicating effects of THC. Such a medication might be
used to prevent relapse to marijuana abuse by lessening
or eliminating its
appeal. |